Behind the Term Sheet: How Inato is Solving the Massive Clinical Trial Access & Diversity Gap

Written by Jean-Francois Cochy, edited by Jaclyn Hartnett, Cathay Innovation

Clinical trials are essential to medical innovation and the development of potentially life-saving drugs. But today, access is wildly off balance —consider this:

● 70% of clinical research happens at the same 5% of sites

● Only 5% of patients participate in clinical trials

● Only 4% of clinical trials in recent years have used a representative population

The lack of patient access and diversity within clinical trials causes delays, increases costs and could impact a drug’s efficacy and safety — hampering medical innovation as a whole.

This is the context that led us to invest in Inato, a leading technology platform enabling inclusive clinical trials, back in 2019. Today, we’re excited to share our renewed support by leading its latest $20M funding round alongside Obvious Ventures, La Maison and Top Harvest Capital — bringing total funding to $36M to date.

While starting as an interesting way to address the pain point of site selection for pharmaceutical groups, Inato has dramatically evolved over the past few years to become the trusted partner of hospitals and doctors to find the right clinical trials for their patients.

While we’re still in the early days, we’re extremely optimistic about Inato’s potential and what it means for the future for patients, doctors and clinical research as a whole. Here’s our view on the Inato story and what’s ahead.

The Issue at Hand — The Clinical Trial Access Gap

Historically, hospital selection was very manual and mostly relied on past experience between pharma groups and very large hospitals such as Mayo Clinic, Cleveland Clinic, etc. — resulting in only 5% of hospitals running 70% of all clinical trials.

This means that the vast majority of patients are not given the chance to participate in clinical trials, which in some disease areas, is the only therapeutic option. Adding to the general lack of availability, people from ethnic minorities and other diverse groups are hugely underrepresented — creating issues around proving efficacy of new treatments to entire populations.

This issue is clearly identified by FDA Commissioner Robert M. Califf, MD in saying:

“U.S. population has become increasingly diverse, and ensuring meaningful representation of racial and ethnic minorities in clinical trials for regulated medical products is fundamental to public health.”

With the rise of precision medicine, pharma groups increasingly struggle to find the right patients that not only fit clinical trial criteria but are representative of the real population. And in some pathologies, competition is fierce for a very limited number of patients being treated at the large national hospitals they typically pool from. This complicates recruitment campaigns and often leads to delays or halting clinical trials of promising new drugs altogether.

Why not simply expand to more hospitals? The current model relies on a high level of trust with doctors in the field which is difficult to scale at community hospitals (small to mid-size community-based hospitals). Pharma companies and their CRO (contract research organizations) partners simply don’t have the time to build trust in each community, representing less than 5 potential patients per site — essentially leaving pharma companies blind to patient recruitment beyond historic hospital networks.

Enter Inato — Unlocking Clinical Trial Access in the Community

When we first met with Kourosh Davarpana (Inato co-founder & CEO) in 2019, the company was supporting few pharmaceutical groups with their clinical trial feasibility, i.e., planning the number of hospitals that would be included in a given trial in order to match the required number of patients to get a new drug approved for commercialization.

In doing so, the team discovered that 95% of hospitals were poorly or not at all represented in clinical research — despite a significant portion having research capabilities. Thus, Inato decided to flip its model to create an open platform connecting community hospitals and clinical trials. With Inato, hospital staff can see upcoming trials and position themselves for research of interest to them or their patients. It also helps hospitals communicate relevant information to pharmaceutical groups to increase the chances of qualifying for a given trial.

Inato’s unique approach to engage community hospitals massively enlarges the pool of patients that can participate in clinical trials while helping to solve the existing diversity issue. On top of this, it uses data from past trials (along with information provided by hospital staff) to predict more precisely the ability of a hospital to recruit patients in a given pathology. This enables pharma groups to run studies with a more predictable timeline and avoid falling short of the required number of patients in the drug approval process — improving enrollment performance for the benefit of the entire health system.

This is made evident with compelling data: hospitals connected to the Inato platform are activated and enroll patients at a much faster rate (over 2X) and among a much more diverse set of patients.

Today Inato has been adopted by over 2,600 hospitals and research centers across 60 countries, supporting 70 disease areas. It also already works with 10 out of the top 30 largest pharma groups in the world while continuously evolving its partnerships — including with Sanofi, a strategic partner and investor of Cathay Innovation.

What’s Next: Building the Global Platform for Sponsor-based Clinical Research

Looking forward, Inato will continue expanding its network of hospitals and pharmaceutical groups to massively increase the number of clinical trials available to community sites. It will also focus on improving the matching quality between hospitals and trials on two fronts: (1) by continuing to improve its matching algorithm to enhance prediction capabilities and (2) by partnering with other players along the clinical trial value chain to get real-time data on qualified patients.

In the future, we believe Inato has great potential to significantly reduce the lead time between pre-clinical studies and drug approval — ultimately enabling patients to get innovative treatments faster. At Cathay Innovation, we’ve witnessed the team work tirelessly to refine its model and product positioning while adapting to crucial pain points for hospitals. We’re proud to continue our partnership with Inato in its impactful mission of making clinical trials more accessible, inclusive and efficient.